COMPARATIVE EVALUATION OF OSTEOSYNTHESIS METHODS FOR MANDIBULAR CONDYLE FRACTURES

Львівський медичний часопис / Acta Medica Leopoliensia Open Journal Systems Допомога Користувач Ім'я користувача Пароль Запам'ятати мене Сповіщення Дивитися Передплатити Мова Зміст журналу Пошук Перегляд За номером За автором За назвою Розмір шрифта Make font size smaller Make font size default Make font size larger Інформація Для читачів Для авторів Для бібліотекарів Домашня сторінка Про нас Увійти Пошук Поточний випуск Архіви публікаційна етика Домашня сторінка > Том 20, № 2 (2014) > KOPCHAK COMPARATIVE EVALUATION OF OSTEOSYNTHESIS METHODS FOR MANDIBULAR CONDYLE FRACTURES P.9-17 A.V. KOPCHAK Анотація Aim. To perform a comparative assessment of different methods of condylar process osteosynthesis and to determine their clinical efficacy by analyzing immediate and long-term treatment results. Methods. Results of 146 mandibular condyle osteosynthesis with the use of different types of fixators were analyzed. Kirschner needles were used in 18.5% of cases, strait plates - in 13%, L and Y-shaped plates - in 32.2%, a combination of needles with others types of fixators - in 4.8%, 2 plates located at an angle to each other - in 9%, lag screws - in 1.5%. In 9.5% of cases with high condyle fractures and medial dislocation, osteoplastic reposition of the condylar head was performed. In 10.2% of cases, fragments of the condylar head were removed followed by mandibular ramus osteoplasty or artificial titanium endoprosthesis arthroplasty (1.5%). Quality of fragments reposition and fixation was assessed based on the clinical data and control radiography; duration of the intervention, incidence of complications, and character of occlusal and articulation disorders in the long term postoperative period were also considered. Results. The effectiveness of surgical treatment for condylar fractures depended on the type and location of the fracture, the applied method of fixation, and functional loading conditions in the postoperative period. Immediate and longterm outcomes were significantly better (p <0,05) in low subcondylar fractures. No significant differences in the clinical effectiveness of different methods of fixation were found in biomechanically-favorable linear fractures. Instead, in biomechanically-unfavorable oblique and comminuted fractures the most appropriate method was the usage of 2 miniplates, while the other methods of fixation were insufficient. In cases of intra-articular fractures the best results were achieved using treatment methods allowing to preserve the viability of the condylar head and to ensure its correct reposition. Conclusions. The effectiveness of surgical treatment for mandibular condyle fractures depends on type, location of fracture, and applied method of fixation. In biomechanicallyfavorable linear fractures, adequate fixation can be achieved using different fixator types, while in oblique or comminuted fractures the method of choice is to use 2 miniplates located at an angle to each other. Keywords: mandibular fractures, condylar process, osteosynthesis, miniplates